Tenet paid $1.8 billion in cash, or $21 per share of Vanguard stock, and agreed to assume $2.5 billion of Vanguard's debt, giving the transaction a total value of $4.3 billion.

"Through this acquisition, we have significantly increased our scale and expanded the services we offer," Trevor Fetter, president and CEO of Tenet, said in a news release. "We intend to be a leader in addressing the opportunities in our healthcare system, and we are strongly positioned to drive improvements in quality and value for the millions of people to whom we provide care."

Tenet, which will maintain headquarters in Dallas, now owns and operates 77 acute-care hospitals, 173 ambulatory surgery centers and outpatient facilities and five health plans. It also could add several more hospitals into its system, as Vanguard has been working on a few hospital acquisitions in Connecticut, such as Eastern Connecticut Health Network in Manchester. Tenet, which now has more than 100,000 employees, also oversees six accountable care organizations.

Tenet currently stands as second-largest for-profit hospital chain in terms of revenue and the third-largest in number of hospitals owned. Further, Tenet gained market share in areas it previously had no footprint, such as Chicago, Detroit, San Antonio, Phoenix and New England — giving it the number one or two position in 19 major markets.

Tenet announced plans to acquire Vanguard in June. Vanguard, which has ceased trading on the New York Stock Exchange as of today, produced a large payday for its largest shareholder, New York City-based private equity firm Blackstone Group. According to a Bloomberg Businessweek report from earlier this summer, Blackstone should receive $617 million from the sale.

Since the merger was announced, Vanguard also had to settle two lawsuits that claimed the transaction was approved through "an unfair process and at an unfair price."